A new test that enables diagnosis of hepatitis C infection in a single visit could improve access to early diagnosis, monitoring, and treatment service for some of the most vulnerable people in Australia and the world, according to a study published today by the Kirby Institute, UNSW Sydney in The Lancet Gastroenterology & Hepatology.
Researchers conducted the first evaluation of the Xpert HCV Viral Load test (manufactured by Cepheid) - a point-of-care hepatitis C virus test that can detect active infection - from a finger-stick sample of blood. They established there is good sensitivity and specificity of the Xpert HCV Viral Load point-of-care test using blood samples collected by finger-stick in participants attending drug health and homelessness services in Australia.
"This test represents a major advance over point of care antibody-based tests, which only indicate previous exposure to the virus but cannot detect whether you are actively infected," said Associate Professor Jason Grebely, lead author of the study from the Kirby Institute. "We really need to scale up testing for active hepatitis C infection in order to enhance diagnosis, get people linked to appropriate care, and provided highly curative treatment with direct-acting antivirals to prevent advanced liver disease and onward transmission of the virus."
Importantly, new point of care platforms enable detection of hepatitis C virus and diagnosis of active infection in a single visit, rather than having to come back for a second visit to obtain test results.
"Requiring people to come back for a second appointment to receive their results can present significant barriers, especially for people living in remote areas and for vulnerable and marginalised populations like homeless people and people who inject drugs, who are the people we need to reach the most in order to eliminate hepatitis C," said Associate Professor Grebely.
The Xpert HCV Viral Load finger-stick test is not yet registered in Australia, but international clinical trials are underway to evaluate this point of care assay as a diagnostic test for the detection of active HCV infection.
This study is part of the LiveRLife project - an open observational cohort study evaluating the effectiveness of an intervention integrating non-invasive liver disease screening on HCV assessment and treatment uptake.
Funding was provided by The National Health and Medical Research Council (Australia), Cepheid, South Eastern Sydney Local Health District (Australia), and Merck Sharp & Dohme (Australia).
Article: Evaluation of the Xpert HCV Viral Load point-of-care assay from venepuncture-collected and finger-stick capillary whole-blood samples: a cohort study, Jason Grebely et al., The Lancet Gastroenterology & Hepatology, doi: 10.1016/S2468-1253(17)30075-4, published 22 April 2017.